Undiagnosed chicken meat aspiration as a cause of difficult-to-ventilate in a boy with traumatic brain injury

• Main Authors: Nazhan Afeef Mohd Ariff, Mohd Zulfakar Mazlan, Mohd Erham Mat Hassan, Praveena A/p Seevaunnamtum, Wan Fadzlina Wan Muhd Shukeri, Nik Abdullah Nik Mohamad, Shamsul Kamalrujan Hassan, Kamaruddin Jaalam, Mohamad Hasyizan Hassan, Sanihah Che Omar, Chandran Nadarajan, Irfan Mohamad
• Format: Article
• Language: English
• Published: Elsevier 2018-01-01
• Series: Respiratory Medicine Case Reports
• Online Access: http://www.sciencedirect.com/science/article/pii/S2213007117303933

Introduction: Bronchoscopy is a commonly used procedure in the context of aspiration in the Intensive Care Unit setting. Despite its ability to remove mucus plug and undigested gastric contents, aspiration of gastric content into the trachea is one of the most feared complications among anesthesiologist. Discussion: The scenario is made worst if the aspiration causes acute hypoxemic respiratory failure immediately post intubation. However, in the event of desaturation, the quick decision to proceed with bronchoscopy is a challenging task to the anesthesiologist without knowing the causes. Case presentation: We present a case of a 12-year-old boy who had a difficult-to-ventilate scenario post transferring and immediately connected to ventilator in operation theatre (OT) from portable ventilator from the emergency department. She was successfully managed by bronchoscopy. Conclusion: Special attention should be given to the difficult-to-ventilate scenario post intubation of traumatic brain injury patient prior to operation. Prompt diagnosis and bronchoscope-assisted removal of foreign body was found to be a successful to reduce morbidity and mortality. Keywords: Foreign body, Aspiration, Chicken meat, Difficult ventilation